Nutrition and HIV/AIDS: A Training Manual - Linkages Project

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TABLE OF CONTENTSAcknowledgementsAbbreviations and AcronymsIntroduction to the ManualiiivviSession 1 Introduction to HIV/AIDS 1Session 2 Link between Nutrition and HIV/AIDS 21Session 3 Key Nutrition Actions for People Living with HIV/AIDS37Session 4 Food Security Components in HIV/AIDS Nutritional Care andSupport62Session 5 Nutritional Management of HIV/AIDS-Related Symptoms 97Session 6 Nutritional Care and Support of Pregnant or Lactating Womenand Adolescent Girls Infected with HIV/AIDSSession 7 Prevention of Mother-to-Child-Transmission of HIV and InfantFeedingSession 8 Nutritional Care for Young Children Infected with HIV or Born toHIV-Infected Mothers117182216Session 9 Management of Drug and Food Interactions in HIV/AIDS Therapy 240iv
ABBREVIATIONS AND ACRONYMSACCAIDSANCARVARTCRHCS-ESAESAROFANTAFAOHIVHMISIECIMCIMOHMTCTNGOPCRPLWHAPMTCTRCQHCRDAREDSOSARASTIAdministrative Committee on Coordinationacquired immune deficiency syndromeantenatal careantiretroviralantiretroviral therapyCommonwealth Regional Health Community Secretariat for East andSouthern AfricaEast and Southern Africa Regional OfficeFood and Nutrition Technical Assistance ProjectFood and Agriculture Organizationhuman immunodeficiency virushealth management information systeminformation, education, and communicationIntegrated Management of Childhood IllnessMinistry of Healthmother-to-child transmission of HIVnongovernmental organizationpolymerase chain reactionpeople living with HIV/AIDSprevention of mother-to-child transmission of HIVRegional Centre for Quality of Health Carerecommended daily allowanceUSAID Regional Economic Development Support Office for East andSouthern AfricaSupport for Analysis and Research in Africa Projectsexually transmitted infectioniv
Page 1 and 2: Regional Centrefor Quality ofHealth
Page 3: ACKNOWLEDGMENTSThis training manual
Page 7 and 8: INTRODUCTIONThe coexistence of high
Page 9 and 10: ContentThe content is arranged in t
Page 11 and 12: The sessions can also be taught in
Page 13: OutlineContent Methodology TimingDe
Page 16 and 17: LECTURE NOTES 1: THE BASICS OF HIV/
Page 18 and 19: gradually weakened. The infected pe
Page 20 and 21: increase in HIV prevalence of 60 pe
Page 22 and 23: infection may have a rapid onset, l
Page 24 and 25: • Dot-blot immunobinding assayUri
Page 26 and 27: • Removal of children from school
Page 28 and 29: effectively, care and support inter
Page 31 and 32: DISCUSSION POINTS 1================
Page 34 and 35: Recommended preparation1. Be famili
Page 36 and 37: LECTURE NOTES 2: LINK BETWEEN NUTRI
Page 38 and 39: AIDS, the impairment of immune func
Page 40 and 41: for healthy, non-HIV-infected peopl
Page 42 and 43: Low blood levels of several nutrien
Page 44 and 45: • Finally, a study of AIDS patien
Page 46 and 47: EXERCISE 2=========================
Page 48 and 49: SESSION 3 NUTRITION ACTIONS FOR PEO
Page 50 and 51: Required materials• LCD or overhe
Page 52 and 53: McDermott, AY, A Shevitz, T Knox, R
Page 54 and 55:
Goals of nutritional care and suppo
Page 56 and 57:
• Circumferences of the waist, hi
Page 58 and 59:
Consider the phase of the HIV infec
Page 60 and 61:
Promote adequate nutrient intake (s
Page 62 and 63:
Stages of illness and symptoms. Sym
Page 64 and 65:
TherapyNitrogenretention[g/day]Rate
Page 66 and 67:
Nutrient supplements for people liv
Page 68 and 69:
Conclusion (slide 31)Nutritional ca
Page 70 and 71:
HANDOUT 3.1 Case studies in HIV and
Page 72 and 73:
HANDOUT 3.2 Safe Food Handling Prac
Page 74 and 75:
OutlineContent Methodology Timing1.
Page 76 and 77:
Recommended preparation• Be famil
Page 78 and 79:
PVO-USAID Steering Committee on Mul
Page 80 and 81:
Nutritional care and support of peo
Page 82 and 83:
In this session “food security co
Page 84 and 85:
HIV/AIDS attacks food security not
Page 86 and 87:
• Human capital: Reduced producti
Page 88 and 89:
Food-insecure populations may also
Page 90 and 91:
Food security constraints to nutrit
Page 92 and 93:
Pregnant and lactating women (slide
Page 94 and 95:
Implementation of nutritional care
Page 96 and 97:
demand these foods. A good assessme
Page 98 and 99:
Counselors should be aware of and i
Page 100 and 101:
Conclusion (slide 36)The capacity t
Page 102 and 103:
UNAIDS and WHO. 2002. AIDS epidemic
Page 104 and 105:
1. How does poor food availability
Page 106 and 107:
5. Will referrals and targeting of
Page 108 and 109:
SESSION 5 NUTRITIONAL MANAGEMENT OF
Page 110 and 111:
Required materials• LCD or overhe
Page 112 and 113:
LECTURE NOTES 5: NUTRITIONAL MANAGE
Page 114 and 115:
Figure 2 Cycle of malnutrition and
Page 116 and 117:
IV. Late symptomatic phase (full-bl
Page 118 and 119:
The following symptoms may also neg
Page 120 and 121:
• Enables greater food intake by
Page 122 and 123:
EXERCISE 5=========================
Page 124 and 125:
HANDOUT 5.1 Caring for symptoms ass
Page 126 and 127:
Illness Diet Care and nutrition pra
Page 128 and 129:
SESSION 6 NUTRITIONAL CARE AND SUPP
Page 130 and 131:
Page 132 and 133:
Recommended preparation• Be famil
Page 134 and 135:
———. 1998. Randomised trial o
Page 136 and 137:
LECTURE NOTES 6: NUTRITIONAL CARE A
Page 138 and 139:
The stigma associated with HIV can
Page 140 and 141:
of malnutrition, which increases th
Page 142 and 143:
adolescent mother, growth and devel
Page 144 and 145:
HIV infection increases the energy
Page 146 and 147:
Anemia is common during HIV infecti
Page 148 and 149:
The use of high levels of supplemen
Page 150 and 151:
Nutritional care and support for th
Page 152 and 153:
Management of secondary infections
Page 154 and 155:
A. Nutrition history• Dietary int
Page 156 and 157:
• Income, housing, amenities for
Page 158 and 159:
multiple nutrient supplement, where
Page 160 and 161:
Management of diet-related HIV prob
Page 162 and 163:
Infant feeding options and risks (s
Page 164 and 165:
insecurity and may increase malnutr
Page 166 and 167:
Seumo-Fosso, E, and B Cogill. 2003.
Page 168 and 169:
HANDOUT 6.1 Health Sector and Mater
Page 170 and 171:
HANDOUT 6.2 A Guide to Nutritional
Page 172 and 173:
• Educational levelLactating moth
Page 174 and 175:
Did the counselor ask about: YES NO
Page 176 and 177:
HANDOUT 6.4 Practical Consideration
Page 178 and 179:
HANDOUT 6.5 Checklist for Nutrition
Page 180 and 181:
HANDOUT 6.7 Dietary Management of C
Page 182 and 183:
Dietary problemFeverNutritional int
Page 184 and 185:
1. How could HIV infection affect R
Page 186 and 187:
• Nutritional status, dietary int
Page 188 and 189:
• Rita’s dietary intake and eat
Page 190 and 191:
• Eating smaller, more frequent e
Page 192 and 193:
• How was the nutritional assessm
Page 194 and 195:
Estimated time: 120 minutes excludi
Page 196 and 197:
Suggested reading materialsCoutsoud
Page 198 and 199:
LECTURE NOTES 7: INFANT FEEDING AND
Page 200 and 201:
• A viral, bacterial, or parasiti
Page 202 and 203:
DNA (cell-associated virus) in colo
Page 204 and 205:
Mucosal integrity (slide 18)Studies
Page 206 and 207:
PMTCT interventions are most effect
Page 208 and 209:
Breastfeeding techniquesIt is espec
Page 210 and 211:
women with HIV/AIDS for additional
Page 212 and 213:
• Providing skin-to-skin contact
Page 214 and 215:
suitable for replacement feeds befo
Page 216 and 217:
• Administration of ZVD and Lamiv
Page 218 and 219:
Coutsoudis, A, et al. 2001. Are HIV
Page 220 and 221:
Semba, RD, N Kumwenda, D Hoover, et
Page 222 and 223:
Case study 1A school teacher, Regin
Page 224 and 225:
• How would you respond to Hilary
Page 226 and 227:
HANDOUT 7.2 PMTCT Decision-Making A
Page 228 and 229:
OutlineContent Methodology Time1. E
Page 230 and 231:
Suggested reading materialsAgostoni
Page 232 and 233:
LECTURE NOTES 8: NUTRITION AND HIV/
Page 234 and 235:
Despite these statistics, it is dif
Page 236 and 237:
Etiology of growth failure among HI
Page 238 and 239:
oys. Micronutrient deficiencies wil
Page 240 and 241:
• Changes in eating behaviors ass
Page 242 and 243:
• Address issues relevant and of
Page 244 and 245:
Enhanced ARV therapy (slide 29)Chil
Page 246 and 247:
• Refer children with severe maln
Page 248 and 249:
DISCUSSION POINTS 8Questions for cl
Page 250 and 251:
Action/activityNorman admitted to n
Page 252 and 253:
Page 254 and 255:
• Allocate time for each activity
Page 256 and 257:
Food Medication Interactionswww.foo
Page 258 and 259:
• Describes information collected
Page 260 and 261:
• Antimalaria drugs such as quini
Page 262 and 263:
Food effects on drug efficacy (slid
Page 264 and 265:
Some antiretroviral drugs may affec
Page 266 and 267:
MedicationPurposeRecommended Tobe t
Page 268 and 269:
intake and poor nutrient absorption
Page 270 and 271:
Anti-acid medications containing ma
Page 272 and 273:
women’s nutritional status. It is
Page 274 and 275:
Health provider capacityHealth prov
Page 276 and 277:
• What foods should not be taken
Page 278 and 279:
Gelato, M. 2003. Insulin and carboh
Page 280 and 281:
eferred him to the counselor for th
Page 282 and 283:
Medication Purpose Recommended Tobe
Page 284 and 285:
Medication Purpose Recommended Tobe
Page 286 and 287:
Side effects of each drug?Side effe
Page 288 and 289:
PurposeTo provide basic information
Page 290 and 291:
Factors in Transmissionand Vulnerab
Page 292 and 293:
Impact on the Education Sector• D
Page 294 and 295:
AcknowledgmentNutrition and HIV/AID
Page 296 and 297:
Body Habitus ChangesMetabolic chang
Page 298 and 299:
PurposeTo provide general nutrition
Page 300 and 301:
Stages of HIV Disease andNutritionI
Page 302 and 303:
IncreaseVitamin and Mineral IntakeS
Page 304 and 305:
Lipodystrophy• Means fat maldistr
Page 306 and 307:
PurposeTo introduce the constraints
Page 308 and 309:
Effect of AIDS on Crop ProductionCr
Page 310 and 311:
Pregnant and Lactating WomenFood an
Page 312 and 313:
Session 5 Nutritional Management of
Page 314 and 315:
Rationale, Cont.Importance of Manag
Page 316 and 317:
Session 6 Nutritional Care and Supp
Page 318 and 319:
Vulnerabilityof Women and Young Gir
Page 320 and 321:
What Is Not KnownComparison of Nutr
Page 322 and 323:
Purposeof Nutrition Care and Suppor
Page 324 and 325:
Greatest Impact of NutritionImprove
Page 326 and 327:
Size of the Problem in Africa• >3
Page 328 and 329:
Possible Mechanisms ofTransmissionA
Page 330 and 331:
Prevention-to-Care ContinuumInterve
Page 332 and 333:
Session 8 Nutritional Care for Youn
Page 334 and 335:
ChildrenBorn to HIV-Positive Mother
Page 336 and 337:
Growth Failure Associated withIncre
Page 338 and 339:
Enhanced ARV Therapy• To reduce v
Page 340 and 341:
Care of the Terminally Ill ChildWhy
Page 342 and 343:
PurposeTo provide knowledge and ski
Page 344 and 345:
SIDE EFFECTS OF DRUGSaffectFOOD INT
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